Mastalgia-breast pain

Many women go to see a doctor because they have some kind of pain in the breasts, writes Dr Marga Boyani

Breast pain is called mastalgia and there are two types: Cyclical and non-cyclical.

Cyclical mastalgia is the most common type of breast pain and women in their 20s are the most affected though it can last until menopause.

It is the discomfort that a woman gets just before and during her period when the breasts swell and become tender and lumpy. Some women begin to have pain around the time of ovulation, and this can continue until the beginning of their periods.

Cyclical mastalgia can be so severe that the woman cannot wear tight-fitting clothing or tolerate close contact.

A change in the balance of the sex hormones oestrogen and progesterone in the second half of the menstrual cycle is the main cause of cyclical mastalgia. This is because a woman’s breasts are also organs of reproduction and they mirror what is happening in the uterus during each menstrual cycle.

As the uterus is prepared for pregnancy by these hormones during each menstrual cycle, the breasts too are prepared for breastfeeding. As a woman gets her periods when she does not get pregnant, the breasts undergo other changes too.

Breasts also swell and can become painful as a normal part of pregnancy and breast-feeding and you may also get breast pain when approaching menopause.

Hormonal changes caused by emotional stress can also increase or change the pattern of breast pain. Adolescent boys may also get breast pain when the breasts enlarge as a normal part of their development. Weight gain and women with a larger bra size suffer cyclical mastalgia more often.

No cure

Cyclical mastalgia does not have a cure. You may need to chart your breast pain on a calendar to determine if the pain is cyclical or not and after a few months, the relationship between the menstrual cycle and breast pain will emerge. The treatment given is for relieving the pain and a combination of anti-inflammatory painkillers, warm breast compresses and a firm bra usually works well.

Non-cyclical mastalgia is breast pain that is due to a problem within the breast itself or from nearby tissues like the chest muscles or joints. It feels different from cyclical mastalgia. It is present all the time and is in only one specific place.

Because it is not due to any hormonal changes in the body, it does not vary with the menstrual cycle.

One cause of non-cyclical mastalgia is injury to the breast because the breasts’ rich blood supply makes them bleed easily from impact.

It may also be caused by pain from arthritis of the small joints in the chest wall and in the neck, which radiates down to the breast as well as shingles and certain medications.

Muscle tissues

Exercise can also cause non-cyclical mastalgia because a woman’s breasts were not created with running and jumping in mind and have no true supporting ligaments or muscle tissues of their own. Too much motion during sporting activities will, therefore, cause pain and sagging.

Is the pain a sign of cancer?

The answer to this is no. There is no breast pain with breast cancer unless the cancer is advanced. Any woman worried about breast pain should see their doctor who will examine the breasts and decide whether there is need for any tests.